This proposal is a competing continuation request for T32 NR 07104 funded in 1999 for the purpose of training nurse investigators in nursing outcomes research. It is a formal interdisciplinary program of predoctoral and post-doctoral study comprising the conceptual and empirical foundations and the methodologic approaches and statistical tools of advanced outcomes research. Research training in this program directly interfaces with related pre- and post-doctoral training programs across the University of Pennsylvania providing a network of training opportunities for fellows that augment the rich experiences offered within the School of Nursing. The program is founded on nursing's conception of the relationships between systems, clients, and outcomes depicted in the Quality Health Outcomes Model developed by the American Academy of Nursing's Expert Panel on Quality Health Care. It has as its goal the development of a cadre nurse researchers whose work will advance nursing science through rigorous testing and validation of this conceptual model for nursing outcomes research. The present grant funds 3 pre-doctoral and 4 postdoctoral fellows. We are requesting in the competing continuation increased funding to allow for 4 predoctoral fellows and to maintain the existing 4 post-doctoral positions. Our pre-doctoral program in outcomes research emphasizes direct admission to the Ph.D. program post baccalaureate degree in order to attract fellows who are just entering graduate study, a model comparable to the training of scientists in other fields. Thus it is to be expected that our pre-doctoral fellows will require 4 to 5 years to complete doctoral study. With only 3 pre-doctoral positions we are unable to accept a new fellow every year which is important to the vitality of the program. The program's first 4 years have been highly successful in terms of the recruitment of talented fellows including minorities, high visibility scientific publications by faculty and fellows, success of our fellows in competing for extramural grant funds, and the placement of those who have completed their fellowships in mainstream research positions where their research careers can continue to flourish. An External Review of the T32 program in nursing outcomes research is highly complementary and supports program continuation.